A dozen people sit at desks set up in a horseshoe pattern around the perimeter of a room the size of a mid-level executive’s office, eyes fixed on computer screens, ears glued to telephones.

At first glance, it might appear to be the backroom of a travel reservation site or the help desk for a computer service company. In fact, it’s the Bronx-based “nerve center” atEssenMED House Calls, the largest private practice-based program of its kind in New York State. It’s where shifts of care coordinators field an estimated 250 – 300 phone calls during a 12-hour day (8 a.m. – 8 p.m.), mostly from poor and elderly patients and their caregivers, and make perhaps four times as many outgoing calls in support of their callers’ needs. “It’s all about coordinating the care of our more than 3,000 House Call patients,” said Freddy Fortoso, EssenMED House Calls’ Adminitrator, who has been overseeing the team since 2005 when the House Calls program began and there were just 40 patients. “It’s a one-stop shop and many of our callers are in desperate need of answers.”

They call not only about scheduling providers to come to their homes, but to find nearby specialists, learn about home care attendants, get wheelchairs or oxygen tanks, have lab tests done, find out what their insurance will and will not cover, have their medications delivered. “We explain and take them through the process,” said Fortoso. “They may be looking for a nursing home for a loved one and need documentation, or they may not know how much medication they should take, or how the medical equipment they just had delivered works. Many are agitated when they call or, because they are elderly and infirmed, and sometimes have cognitive impairment, hard to understand. It can be a battle, but it doesn’t matter. Our job is to take control of the situation and help them find the answers they need.”

While listening to patients or their caregivers on the phone, the coordinators access on their computer screens the callers’ medical information from EssenMed’s electronic medical record system. Several members of the team are trained as medical assistants. More medically-oriented questions are transferred to a clinical coordinator, who sits at the far corner of the room. “They may say they are having shortness of breath, or are confused about their different medications,” said Jignesh Patel, who graduated medical school in India and is waiting to start a medical residency in the U.S. Questions he can’t answer are kicked upstairs to the EssenMED House Calls’ physicians.

The team “triages” each call. Jessica checks the insurance and schedules new patients (15 or so a day), while Liz deals with lab tests and medical equipment, Ellie arranges transportation, and Blanca handles calls for home attendants. All of the service reps are bilingual, as 80 percent of the callers consider Spanish their primary language. About 60 percent of the calls come from the Bronx now, as EssenMED has expanded its reach over the last 18 months to include all five boroughs and lower Westchester.

The House Calls program is the brainchild of Dr. Sumir Sahgal, the medical director of Essen Medical Associates, which also has six medical offices in the Bronx. Years ago, Dr. Sahgal began to invest in a sophisticated health informational infrastructure that now allows for easy access to patient records, updated in real time. He sends out nearly 20 practitioners every day to visit homebound patients. He has also established many relationships – with labs, durable medical equipment companies, pharmacies and home care agencies – that allow for the smooth coordination of different patient services. “Many times, our callers don’t know what’s possible,” said Fortoso. “They don’t know, for example, they can get pre-poured medication delivered to them, or that their insurance will cover the cost of diapers. We connect them and do a lot of hand holding – and we don’t let go until the issues or questions are resolved.”

Fortoso admits that often they need to “play Sherlock Holmes” in getting to the bottom of a problem.

“They may not remember who the insurance carrier was when they first got a piece of medical equipment that no longer works,” he said. “They may need to find a pulmonologist in Queens or transportation to get to a hospital in lower Westchester. In many cases, we deal with social service-type rather than clinical questions. People are hungry and we connect them with Meals on Wheels, or they have a problem at home that requires a social worker. Our job, regardless of the question, is to find an answer.”

Fortoso remembers one cognitively-impaired patient who stayed on the phone with his team throughout the entire day; many others call daily. “And if we don’t hear from them, we call them to make sure they’re ok,” said Fortoso. “After all, they don’t have anyone else they can call. We’re their lifeline.”

THE BRONX – A Bronx mother of a bedridden daughter says her child now is getting health care from the comfort of her own home.

Amelia Rose’s daughter, Azuredee, who lives in a Grant Avenue building, has had trouble with her health since birth. Rose is now part of the Essen Medical Associates House Calls program.

The program, which has six offices in the Bronx, sends doctors and other caregivers to homes of bedridden and elderly patients. Health workers use mobile technology and health kits that allow patients to transform their homes to hospital rooms. Essen Medical Associates accepts many insurance plans, including Medicare.

(Bronx, New York, July 11, 2012) – On Thursday, July 11th, EssenMED House Calls brought together a group of its New York City patients over 100 years of age to celebrate its 8th Anniversary of providing medical care to the city’s elderly homebound. New York City Council Speaker, and mayoral candidate, Christine Quinn and State Senator Gustavo Rivera (D-Bronx) were on hand to address the group of patients who were honored alongside family members and care takers. The life longevity of these seniors is in no small part due to the extraordinary collaboration that takes place on a daily basis among families, caregivers, medical providers, and home care services – making sure that these seniors are well cared for and remain in the comfort of their homes for as long as possible.

As part of the day’s festivities, City Council Speaker Quinn issued a Proclamation to Dr. Sumir Sahgal, Medical Director of EssenMED House Calls and Essen Medical Associates, P.C. The Proclamation recognizes Dr. Sahgal’s longstanding commitment to providing much needed access to medical care through his various medical offices located in some of the most medically underserved areas of the Bronx. Access to primary care services is especially vital to such communities as the Bronx was recently ranked 62nd out of 62 New York State Counties in terms of Health Outcomes. Moreover, his house call service has been tending to chronically-ill and vulnerable elderly homebound patients since 2005. The service, which brings personalized comprehensive primary care services to patient bedsides, currently cares for nearly 3,000 patients across New York City.

“I feel very proud of what this recognition represents. It is truly a privilege to be honored by the City Council for doing work that I’m very passionate about. Adequate access to quality medical care for all members of the community, regardless of their ability to leave their home, is a right that should be afforded to all New Yorkers” said Dr. Sahgal. “The centenarians we are honoring today embody the primary objective of the services we provide – allowing elderly patients to reside in their homes for as long as their health allows. The need for our services has continued to grow as our population ages, so much so that we are announcing the expansion of our services into Staten Island and later this year into Long Island.”

Through regularly scheduled physician home visits, medication management, and care coordination, EssenMED tends to the primary care needs of chronically-ill homebound patients. In providing this essential service, they are able to intervene at critical points and help avoid costly visits to emergency rooms and admissions into hospitals. EssenMED house calls has been providing primary care, wound, and podiatry services for the homebound population since 2005 and recently expanded it services to provide care coordination and interim care for patients following hospital discharge.

For more information about EssenMED House Calls, please visit www.essenmedhousecalls.org

In 1999, Dr. Sumir Sahgal established Essen Medical Associates, a multispecialty physician group in the Bronx, New York. The practice employs approximately 60 healthcare providers across multiple divisions, including ambulatory, house call, nursing home, and hospital services. In 2008, Dr. Sahgal….. MORE

(Bronx, New York, March 5, 2012) – On Tuesday, March 5th the New York City Commissioner of Health, Dr. Thomas Farley, honored EssenMED House Calls with ride-along with Dr. Sumir Sahgal, Medical Director, and Nurse Practitioner Julius Johnson as they conducted house calls for 2 of our homebound patients. Dr. Farely’s visit marks an increased interest in novel cost-effective care modalities that can help keep our rapidly aging baby-boomer population living safely in the community for as long as possible. EssenMED House Calls has been providing primary care, wound care and podiatry services for the homebound population since 2005 and recently expanded it services to provide care coordination and interim care for patients following hospital discharge.

Following the ride-along, Dr. Farley paid an impromptu visit to our Bronx-based Administrative offices to get a better understanding of the functioning of the “nerve center” that coordinates the care for our nearly 2000 homebound patients residing throughout Manhattan, Brooklyn, Queens, the Bronx, and Westchester.

Alexandra Cohen’s father passed away because of healthcare that was uncoordinated. Not all of his medical records were kept electronically and so were not fully shared between his specialists. Because of this, Alie left a successful career at Microsoft to join the cause of updating health information technology and now works at the non-profit New York eHealth Collaborative (NYeC). Alie’s story is just one of the many reasons that complete and accessible electronic health records are critical, and one of the important stories that will be told at the NYeC gala and awards ceremony next month. Visit nyecgala.org for more information.

In the year since the first NYeC gala, there have been revolutionary advancements in health IT throughout New York and across the nation. On Monday, October 15th, five champions of health IT will be highlighted at the event, which will be hosted by the dynamic Maria Bartiromo, anchor of CNBC’s “Closing Bell with Maria Bartiromo.”

General Electric CEO Jeffrey R. Immelt’s work in standardizing health technology creates a clear path for products being developed across the globe, helping software and other systems work together and making electronic health records accessible from a doctor’s office, to a specialist’s iPad, to a school nurse’s computer.

IBM Chairman Samuel J. Palmisano spearheaded a vision of connected, intelligent healthcare in which the patient is the initial point of design for health systems. Pioneering new models of care and wellness, delivering new technologies that can monitor and analyze health information in real-time, and ushering in a new era of healthcare with advanced computing technology, IBM technology and research helps address some of the most pressing healthcare problems.

The Elmwood Health Center of Buffalo debuted its cutting-edge telemonitoring program this year to help patients with chronic disease keep on track with their care programs. This work was done in partnership with HEALTHeLINK, and the WNY Beacon Program.

New York Health IT practice champion, Dr.Sumir Sahgal, of the Bronx, created a portable health IT system that helps him treat the chronically ill and homebound in his borough.

The pioneering work of Louise West, of Saratoga Springs led to her practice being among the first in New York to achieve the federal “Meaningful Use” health IT designation.

“This is an amazing era for Health IT. We have many milestones to celebrate. This year’s awardees are doing truly meaningful work and it’s an honor to recognize that. We want to champion and learn from the best,” says David Whitlinger, Executive Director of NYeC.

This year’s Gala is part of NYeC’s 2012 Digital Health Conference, held October 15th-16th in New York City. The conference brings together a diverse group of professionals from the healthcare, health IT and other related fields, for two days of lively intellectual exchange. For more information about the Conference and the Gala, and for additional sponsorship opportunities, please visit digitalhealthconference.com.

2012 Gala Details
The New York eHealth Collaborative (NYeC) will host their 2nd annual Gala & Awards Ceremony on Monday, October 15th, to support and honor health IT innovators whose outstanding accomplishments have served to move healthcare forward throughout New York State and beyond. The event will be held on the Manhattan waterfront and include culinary excellence by Abigail Kirsch, live music, good company and insightful conversation. The event is hosted by the NYeC Board of Directors.

Honorees and Award Winners
The 2012 NYeC Gala will honor the Career Achievements in the Advancement of Health IT of General Electric’s Chief Executive Officer, Jeffrey R. Immelt and IBM’s Chairman of the Board, Samuel J. Palmisano, both of whom have shown a long-standing commitment to the advancement of healthcare technology. Immelt’s work with the standardization and interoperability of health systems, improvement of EHRs and mobile healthcare applications, and leadership within GE has revolutionized the industry. Under Palmisano’s leadership, IBM is redefining value in healthcare — through health information exchanges, health analytics and especially IBM Watson for Healthcare, a new kind of cognitive computing system that uses natural language capabilities, hypothesis generation and evidence-based learning to support medical professionals in making faster, better decisions on patient diagnosis and treatment.

The 2012 New York Health IT Visionary award is presented to those whose use of technology measurably improves the lives of its community members through care coordination. This year, NYeC is proud to honor the Elmwood Health Center, of Buffalo, for their work with HEALTHeLINK, and numerous accomplishments as part of the WNY Beacon Program. NYeC will also present the New York Health IT Practice Champion award to Dr.Sumir Sahgal, of the Bronx, and Louise West, of Saratoga Springs, for their pioneering contributions to advancing healthcare through technology, and use of Health IT in their respective areas of practice.

About The New York eHealth Collaborative (NYeC)
NYeC is a not-for-profit organization, working to improve healthcare for all New Yorkers through health information technology. Founded in 2006 by healthcare leaders, NYeC receives funding from state and federal grants to serve as the focal point for health IT in the State of New York. NYeC works to develop policies and standards, to assist healthcare providers in making the shift to electronic health records, and to coordinate the creation of a network to connect healthcare providers statewide. The goal of NYeC is that no patient, wherever they may need treatment within the State of New York, is ever without fast, secure, accurate, and accessible information. www.nyehealth.org.

Dr. Sumir Sahgal moved into private practice in 1999, leaving the hospital setting good bye. For some reason, he felt he could do more, contribute more positively to the community, as a care provider if he was running his own practice.

Since then he’s built a thriving medical practice, Essen Medical Associates, that has 25 healthcare providers who provide services in 20 medical facilities including nursing homes, hospitals and in one of five multi-specialty offices (with more coming online) owned by the practice.

Based in the greater New York City metro area, Sahgal’s practice, a certified medial home, serves more than 15,000 active patients per year. But true to his calling in that he wanted to do even more to provide care to patients, in 2005 he started down a new path that, at the time, most of the people he spoke with said he was making a costly mistake.

Of the population he’s served, there were several dozen (80 patients, in fact) that were home bound. Other than the random hospital visit, they received no care. That is until Sahgal opened EssenMED House Call Service.

EssenMED House Call Service primarily provides care for elderly home-bound patients in the Bronx, Manhattan, Brooklyn, Queens and Westchester. It is currently one of the largest private medical house call programs in New York.

“We opened a house call practice in the Bronx and everyone thought we were crazy,” Sahgal said. “We serve some pretty tough neighborhoods.”

After six months, the practice’s leaders evaluated the program. It made no financial sense to continue the service, he said, but there was an inherent value in the service his practice provided, and that’s all that mattered. The house call service fit his patients’ needs and they were receptive, and word of the program spread.

First slowly and then much more quickly. In seven years, the number of patients has doubled each year. There are now 1,800 being cared for by Essen’s nine caregivers.

“Through word of mouth, patients kept calling,” he said, “and eventually we had enough volume that it created efficiency in the program. Patients gravitate to where they can get the best care.”

The investments the practice made in electronic and mobile technologies also helped. Without his EHR, he currently uses eClinicalWorks, and being able to access patient data through iPad, the house calling practice is almost no different than the office-based practice.

“Healthcare technology helps create efficiency, and since we’ve moved to eClinicalWorks, our coordination of care has gotten much better,” he said.

All of the information needed to care for patients is on hand through mobile technology. In many ways, his staff is just as efficient in the homes of the patients as they are in the practice setting.

Much of the business’ success can be tied directly to the current technology in place.

All of the information is available wirelessly through the practice’s server including labs and documentation. “It’s like truly transferring the office to the home,” he said. “We can prescribe directly from the patient’s house.

The technology has helped him grow his practice and open communication lines with colleagues and share information, as would be expected, making for a much easier documentation process, especially for staff members in the field.

“The technology has helped us improve care and increase patient engagement. With improved patient engagement, patients have better access to their health information, access their medications and communicate with us, which helps us improve care,” he said.

As devices and capabilities continue to improve, Sahgal is confident that the same can be said for patient care, which he’s extremely passionate about. He’s in the business of practicing health to help people have better or more comfortable lives.

His approach is also saving money for the overall system. The more home care is available to patients, the less likely they are to seek care in the hospital. Likewise, the more comfortable patients are as they manage their conditions or approach the end of their lives.

The patient’s response to the technology has been overwhelmingly positive, he said, especially when he’s able to provide video consultations with patients through his iPad and perform remote triages and blood pressure checks from miles away. The services provided by Essen save patients from unnecessary hospital visits and many thousands of dollars in the process.

At this point, one of the next things that can be done to improve care is for interoperable systems to be fully engaged and useable by caregivers despite the vendor in which they employ. But, for now, the technology is in place to allow for the patient to be the central figure in this play, not the technology.

Serving patients in their space and in their areas of comfort is not a common business model and is much easier now than it has been in the past. Dr. Sahgal says his work is his calling, something he does because he loves providing care.

It’s not always easier either: “You are in the field, there are environmental factors to deal with; we have our war stories. But we’re able to provide TLC in the patient’s home, where they are most comfortable,” he said.

(New York, New York, October 16, 2012) – The New York eHealth Collaborative presented Dr. Sumir Sahgal, Medical Director of EssenMED House Calls and Essen Medical Associates, P.C., with the New York Health IT Practice Champion Award at last night’s Gala and Awards Ceremony where other notable honorees included G.E. Chairman & CEO Jeffrey R. Immelt and Samuel J. Palmisano, Former Chairman, President and Chief Executive Officer of IBM.

The Award serves to recognize and honor recent achievement and innovation in the field of health information technology. “Dr. Sahgal has embraced and pioneered technology and used it to dramatically build Essen Medical Associates to great success. But his vision goes beyond the business of medicine. EssenMED House Calls uses health IT to care for the underserved, the chronically ill, the homebound. The program uses technology to arm providers with the information they need to expertly coordinate the care of this extremely needy group of patients, in their homes, where they need it,” said Maria Bartiromo, the evening’s emcee. “You save lives
and measurably improve health care, changing so many people’s lives.”

Dr. Sahgal founded his primary care practice out of one South Bronx office in 1999; the practice will open is 7th location later this year. Essen Medical Associates, P.C. is now one of the largest private a comprehensive multi-specialty medical groups in the Bronx. As one of the initial practices to have achieved ‘Level 3 Patient Centered Medical Home’ designation in New York by the National Committee for Quality Assurance, Essen’s mission is to provide highest quality care to patients by combining latest advances in medicine, patient-centered compassionate care with latest information technology such as electronic medical records and e-prescriptions.

Leveraging the use of HIT by arming providers with real-time access to electronic health records and the ability to eprescribe medications from patient bedsides, in 2005 Dr. Sahgal launched EssenMED House Calls to extend primary care services beyond office walls and into patient homes. EssenMed House Calls is now the largest private practice-based medical house call program in the five borough area. In addition to in-home primary care, the service now offers comprehensive wound care that includes bedside debridement to remove infected tissue, at-home PEG tube replacements, preventing the hospital admissions typically required to perform the
procedure. EssenMED House Calls’ comprehensive services are allowing countless seniors to be treated with dignity in the comfort of their homes. A critical component to reducing avoidable hospitalization and visits to emergency rooms, EssenMED House Calls also partners with a number of local area hospitals to provide interim care to patients following hospital discharge.

Among his notable accomplishments and leadership roles, Dr. Sahgal currently serves as the Chair of the Committee for International Medical Graduates of the Medical Society of the State of New York (MSSNY). He is also an active member of the American College of Physicians, the American Medical Association, the Bronx County, Medical Society, the American Medical Directors Association, and the American Academy of Home Care Physicians.

“It’s truly an honor to be a recipient of the New York Health IT Practice Champion Award. Working in the South Bronx, I found that our senior citizens were among the most medically underserved populations. Striving to provide health care in all types of settings, EssenMED House Calls became a natural extension of our office. Health IT has allowed us to deliver seamless medical care to vulnerable, frail homebound elderly in the comfort of their homes,”said Dr. Sumir Sahgal. “This award will fuel our drive for continued excellence” For more information about EssenMED House Calls, please visit www.essenmedhousecalls.org or visit www.essenmd.com for information about Essen Medical Associates, P.C.

About EssenMED House Calls:
EssenMED House Calls (formerly House Call Medical Services of New York) has over 7 years of experience caring for frail elderly homebound patients in the Bronx, Manhattan, Brooklyn, Queens, and Lower Westchester. EssenMED operates the largest private medical house call programs in the State of New York. Utilizing state-of-the art technology to efficiently deliver high quality care, EssenMED providers travel to patient homes equipped with a laptop to access electronic health records, order diagnostic tests, and send prescriptions electronically while still at the patient’s bedside. EssenMED staff work with patients and their caregivers to develop a
customized plan of care, which may include arranging for additional in-home services such as skilled nursing, home health aides, and delivery of durable medical equipment and medications. Coordination of in-home diagnostics tests and referrals to specialist are also arranged when necessary.